Medical malpractice has again moved to the center of national debate. After President Barack Obama assured Republicans he was open to their health care reform proposals, they renewed their push for malpractice reform, claiming malpractice-related costs are a major culprit in the nation’s bloated health care bill. Democrats have disputed the severity of the problem and put a lower priority on so-called tort reform.

But Obama last week announced he will consider tort reform, although the form it will take remains to be seen. Pennsylvania has collected data on medical malpractice lawsuits in an attempt to understand the situation and to help the public sort out conflicting claims surrounding malpractice.

In 2008, the most recent year available, there were 1,602 malpractice lawsuits in Pennsylvania, compared to 2,632 in 2000. In 2008, 162 of the cases went to trial and 80 percent were won by the health care provider. Of the 32 awards to patients, four were for $10 million or more, and 14 were for between $1 million and $5 million.

In Dauphin, Cumberland, Perry, York and Lebanon counties, seven malpractice cases went to trial, and six were won by the health care provider. In the case won by the patient, the award was between $1 million and $5 million. Jury awards listed in the state report could have been adjusted downward by a judge or settlement.

A recent analysis from the nonpartisan Congressional Budget Office concluded that malpractice related costs, including defensive medicine, are higher than previously believed. Tort reform would have saved about $11 billion, or one half of 1 percent, of the nation’s overall health care bill, in 2009.

A widely cited study on medical malpractice published in the New England Journal of Medicine in 2006 found that about a third of malpractice claims had no merit. Yet the study concluded it was even more common for injured patients to receive no compensation at all, and the authors called attention to previous research suggesting many people injured through medical negligence file no claim. The study also reached this troubling conclusion: 56 percent of awards to injured patients go not to the patient, but to legal and administrative costs.

Dr. Bret DeLone, a Harrisburg-area surgeon, insists that no effort to cut down on unnecessary medial tests and treatments will succeed without tort reform. “As long as the threat exists that a doctor will be treated like a criminal for any bad outcome, defensive medicine will trump any cost-saving measures,” he said.

Cliff Rieders, a malpractice lawyer and patient safety advocate, disputes the impact of defensive medicine, saying health care providers offer all possible tests and treatments because of profit motives, not fear of lawsuits. The biggest problem, according to Rieders, is secrecy surrounding medical errors, and the difficulty in obtaining the truth. The ability to hide errors reduces incentives for health care providers to do better, he said.

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